Cardiovascular Disease in Elderly Women
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Pages 38 - 43
Diastolic heart failure was present in 58% of 110 older black women with CHF, in 56% of 34 older Hispanic women with CHF, and in 57% of 303 older white women with CHF.42
The epidemiology, pathophysiology, prognosis, and treatment of systolic and diastolic heart failure are discussed extensively elsewhere.46 The treatment of systolic and diastolic heart failure in older persons with heart failure is discussed extensively elsewhere.47-49
Valvular Heart Disease
Aortic Stenosis
The prevalence of valvular aortic stenosis increases with age and is similar in elderly women and men.50 In a study, Doppler echocardiography showed that valvular aortic stenosis was present in 17% of 1881 elderly women (mean age, 81 yr).51 The valvular aortic stenosis was severe in 2% of the elderly women, moderate in 5% of the elderly women, and mild in 10% of the elderly women.51 In the Helsinki Aging Study, Doppler echocardiography found that critical valvular aortic stenosis was present in 3% of 501 persons age 75-86 years.52
Management of aortic stenosis in the elderly is discussed extensively elsewhere.50
Aortic Regurgitation
The prevalence of valvular aortic regurgitation increases with age and is similar in elderly women and men.50 Doppler echocardiography showed that valvular aortic regurgitation was present in 29% of 1881 elderly women (mean age, 81 yr).51 The valvular aortic regurgitation was severe or moderate in 16% of the elderly women and was mild in 13% of the elderly women.51
Management of aortic regurgitation in the elderly is discussed extensively elsewhere.50
Mitral Regurgitation
The prevalence of mitral regurgitation increases with age and is similar in elderly women and men.53 Doppler echocardiography showed that mitral regurgitation was present in 33% of 1881 elderly women (mean age, 81 yr).51
Management of mitral regurgitation in the elderly is discussed extensively elsewhere.53
Rheumatic Mitral Stenosis
The prevalence of rheumatic mitral stenosis is higher in elderly women than in elderly men, and was present in 2% of 1881 elderly women (mean age, 81 yr).51
Management of mitral stenosis in the elderly is discussed extensively elsewhere.53
Mitral Annular Calcium
The prevalence of mitral annular calcium is higher in elderly women than in elderly men and was present in 52% of 1881 elderly women (mean age, 81 yr).51
Management of mitral annular calcium in the elderly is discussed extensively elsewhere.53
Peripheral Arterial Disease
Peripheral arterial disease (PAD) is chronic arterial occlusive disease of the lower extremities caused by atherosclerosis. PAD may cause intermittent claudication, which is pain or weakness with walking that is relieved with rest. The muscle pain or weakness after exercise occurs distal to the arterial obstruction. The prevalence of PAD increases with age54 and was higher in 1160 men (32%; mean age, 80 yr) than in 2464 women (26%; mean age, 81 yr).1
Only one-half of elderly persons with documented PAD are symptomatic. Persons with PAD may not walk far or fast enough to induce muscle ischemic symptoms because of comorbidities such as pulmonary disease or arthritis, may have atypical symptoms unrecognized as intermittent claudication,55 may fail to mention their symptoms to their physician, or may have sufficient collateral arterial channels to tolerate their arterial obstruction.
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